| NPI | 1427421023 |
|---|---|
| Former Name | KATIE KORDUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2593-226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18335-130) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2018-10-09 |